Provider Demographics
NPI:1710974126
Name:EWING, MARIA T (LMHC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:T
Last Name:EWING
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-5105
Mailing Address - Country:US
Mailing Address - Phone:941-800-4924
Mailing Address - Fax:419-837-2480
Practice Address - Street 1:4242 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-5105
Practice Address - Country:US
Practice Address - Phone:941-800-4924
Practice Address - Fax:941-837-2480
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6253101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health